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Infective endocarditis and outcomes of mitral valve replacement

Vesa Anttila1, Markus Malmberg1, Jarmo Gunn1

  • 1Heart Center, Turku University Hospital and University of Turku, Turku, Finland.

European Journal of Clinical Investigation
|May 1, 2021
PubMed
Abstract

Insights

Patients with native mitral valve infective endocarditis (IE) face higher mortality and bleeding risks after mitral valve replacement (MVR). Early complication prevention is crucial for improved outcomes in IE patients undergoing MVR.

Area of Science:

  • Cardiovascular Surgery
  • Infectious Diseases
  • Clinical Outcomes Research

Background:

  • Native mitral valve infective endocarditis (IE) poses significant challenges in cardiac surgery.
  • Understanding the long-term sequelae of mitral valve replacement (MVR) in IE patients is critical.

Purpose of the Study:

  • To evaluate the long-term outcomes of MVR in patients with native mitral valve IE.
  • To compare mortality, bleeding events, and other complications between IE and non-IE patients post-MVR.

Main Methods:

  • A multicentre, population-based cohort study included 1233 adult patients undergoing first-time MVR.
  • 170 patients had mitral valve IE; propensity score matching created 134 matched pairs.
  • Median follow-up was 6.1 years.

Main Results:

  • Pre-operative IE was linked to increased 10-year mortality (38.8% vs 30.5%) and higher major bleeding rates (26.0% vs 23.4%) after MVR.
  • IE patients experienced longer hospital admissions (28 vs 11 days).
  • Ischemic stroke and re-sternotomy rates were similar between groups.

Conclusions:

  • Native mitral valve IE significantly increases the risk of death and major bleeding post-MVR.
  • These findings underscore the necessity of proactive complication prevention strategies for IE patients undergoing MVR.
Keywords:
cohort studyinfective endocarditislong-term outcomesurgical mitral valve replacement

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